HIPAA and Minor Volunteers

Esme12, ASN, BSN, RN · Dec 30, 2014

Are you affiliated with a facility at all? Call their compliance helpline.

WalldancerNIT · Dec 30, 2014

I agree....why don't you call the department of health and human services and ask?

Great question. I have in the past and get lost in a rabbit hole of a phone tree. Once I did speak with someone and all she said was, "I don't know", not, "I'll find out". Maybe it's improved since then. Might try them again. Thanks for the reminder

WalldancerNIT · Dec 30, 2014

Why is a health care interest student going to be doing BP checks? Breaking down/scrubbing charts? This sounds like an overwhelming amount of responsibility and exposure to PHI for a HS student.

What is your concern with doing BP checks and basic scrubbing? She's 2 months away from 18 and will have the same liability as any adult. I can't imagine anything changing too much with her maturity or ability to learn in the next 2 months.

WalldancerNIT · Dec 30, 2014

Are you affiliated with a facility at all? Call their compliance helpline.

Nope. We are a community health clinic. We have networks we work with, but we are our own entity, which started in pop-up tents 30 years ago

JustBeachyNurse, LPN · Dec 30, 2014

What is your concern with doing BP checks and basic scrubbing? She's 2 months away from 18 and will have the same liability as any adult. I can't imagine anything changing too much with her maturity or ability to learn in the next 2 months.

It's the delegating assessment of a patient (unless directly under the supervision of a certified or licensed professional) to a minor high school child. If working directly with a nurse, not as much concern. My sister wanted to be a nurse since birth any shadowing she did before age 18 or entering nursing school she was not permitted to do pulse, BP checks etc. she could transcribe VS data to the charts but not obtain he data. (And thus was decades before HIPAA). She could help file charts, room patients but other than transcribe (for example VS from nurses note or brain sheet to the VS trend & plot the graph in the chart) she could not be "source" data as a minor or volunteer. As a minor, she could not legally obtain or chart observations. When I worked ED there were limits what the 16&17 year olds could do while on preceptorship in the ED vs those 18+ due to not only labor laws but liability and legal responsibility issues. Even in EMS in my area they must be a cadet until 18 and must ride with two certified adults. They are not permitted on heavy tool or extrication accidents.

Most facilities cannot hire EMT's or CNAs until they turn 18 and can legally sign confidentiality agreements and held legally responsible for their actions. That's the issue with minors they cannot be held legally responsible for their actions nor can they legally sign agreement to HIPAA, privacy or confidentiality agreements.

I understand being a rural area issues are very different than a suburban or city area and your desire to not diminish this students request. Again, I suggest consult with legal services, in your state parents may be able to cosign a confidentiality agreement with their child accepting responsibility for their child's actions; just like I must sign school Internet access agreements with my child for school.

JustBeachyNurse, LPN · Dec 30, 2014

And until the day of her 18th birthday (19th in Nebraska) she is still a minor child in the eyes of the law. Just like you cannot purchase alcoholic beverages until 12:01AM on your 21st birthday. It's not a magical change but a legal line in the sand.

xoemmylouox, ASN, RN · Dec 31, 2014

We have minors that shadow all of the time. The parent and the minor sign the confidentiality agreements in HIM. We do not allow them to access charts, they simply shadow the staff and physicians. If they touch a patient at all the school MUST have them covered under a Liability Insurance (sadly we live in a world of sue happy people) so that is something else to consider. Often we turn down students who want to do their externships with us because of the insurance issue. Many schools do not have students covered by any policy or a very small policy.

toomuchbaloney · Dec 31, 2014

I haven't read all responses to this thread.

In all of my many places of employment volunteers were provided exactly the same HIPAA training as other employees. They sign the same HIPAA statements of compliance. They are vulnerable to discipline/prosecution should they breach confidentiality just like anyone else.

This should not be an issue for you.

JustBeachyNurse, LPN · Dec 31, 2014

I haven't read all responses to this thread.
In all of my many places of employment volunteers were provided exactly the same HIPAA training as other employees. They sign the same HIPAA statements of compliance. They are vulnerable to discipline/prosecution should they breach confidentiality just like anyone else.
This should not be an issue for you.

But the issue is minor children that cannot legally consent to HiPAA or any other confidentiality agreement. Some states permit parents/legal guardians to cosign and take responsibility for their minor child's behavior/actions

toomuchbaloney · Jan 5, 2015

But the issue is minor children that cannot legally consent to HiPAA or any other confidentiality agreement. Some states permit parents/legal guardians to cosign and take responsibility for their minor child's behavior/actions

I have never worked in an environment where minors were allowed to volunteer. Not the NICU, not the PICU, not the Community Health setting, not home care, and not Hospice.

Omaapecm, ASN, RN · Jan 5, 2015

I believe HIPPA applies to anyone, even underage volunteers. I will check with my supervisor and repost. She is HIPPA coordinator.

Here.I.Stand, BSN, RN · Jan 6, 2015

I became a CNA when I was 18 and started working at a local CAH'n'SNF (same building) that summer. Several of the CNAs I worked with were 16 and 17. I started in 1997, so post-HIPAA enactment. I'm not sure if their parents had to sign anything. I would check with your privacy officer--if your clinic is a covered entity, there is one somewhere.